I have a black male specialist who has put me up on a few things related to being a black, male doc in a bigger city:
1) he practices in a suburb that’s literally across the street from the major city limit and is accessible by bus; yet other black docs gave him a lot of shit for his location because he didn’t decide to practice in/near “the community” and he limited access to “the community across to them.
2) he’s trying to remain solo in an era where big systems are basically buying up/squeezing out private practice docs.
3) if you want your practice to succeed, you have to have a certain ratio of private insurance payers compared to Medicaid/Medicare payers. More of the latter means you have to see a lot of folks in a day and don’t get time to actually learn your patients and their issue(s) and treat appropriately. Going back to #2 above; big systems want numbers; like 10-15 mins per patient and X number of patients a day and a week, plus ordering of procedures, some of which are unnecessary but billable. He’s stated corporate medical is not only bad for patients but makes practicing less rewarding and is burning out docs.
4) as stated; costs are high. My guy spent four years in medical school plus a 5 year residency; he has to make a certain amount a year to service the debt and eat. Going back to #1 and #3 above; unfortunately a disproportionate about of folks in “the community” are on Medicaid or Medicare which pays lower rates than private insurance. Simply put, he can’t practice quality medicine and survive without having a ratio that makes the business work.
5) Finally, and it’s unfortunate but true; a black private doc is limited geographical as to where he can setup shop and survive as a business. And even the hospital work is limited; some communities would rather be sick than have a black dude in their health facilities as the doc.
